Many of us are more concerned with how our smiles look than how healthy our teeth are. Don't believe me? Take a look at these numbers: About 80 percent of adults have some form of periodontal disease, which often goes untreated. Most people don't even floss every day, let alone visit the dentist regularly. On the other hand, tooth whitening is a booming business, a market estimated to be about $1 billion in the United States alone.
But there’s much more to dental health than having white teeth. To truly have healthy teeth, you’ll need to learn some unpleasant truths about the dynamics of food, plaque, decay, tartar, and gum disease. None of it is pretty — except for your teeth, which can shine with just a few changes to your diet and dental routine.
WHAT AFFECTS TOOTH HEALTH?
A tooth has a structure similar to a Tootsie Pop. As just about anyone knows, a Tootsie Pop has a hard lollipop outer shell, a soft Tootsie Roll center, and a supporting stick that extends out from the middle of the pop. A tooth has a hard enamel outer shell, a softer dentin center, and a root canal that extends from the middle of the tooth into the jaw. This root canal contains nerves and blood vessels that feed the tooth and keep it alive.
Enamel surrounds the exposed part of the tooth, stopping just inside the gum line. Made primarily of calcium, it is the hardest substance in the body — harder, even, than bone. But unlike bone, enamel cannot regenerate. If the outer shell is breached, the inner part of the tooth becomes vulnerable and can erode down to the root. That’s why any cracks or areas of decay need to be filled by a dentist.
Just under the enamel is the dentin, which contains millions of fluid-filled tubules, tiny canals that lead to the extremely sensitive nerve. When the protective enamel wears away, you’ve got trouble. Cavities, cracks, gum recession, tooth-grinding, brushing too hard, or even eating too many acidic foods can all provide access to the tubules and consequently a tooth’s nerve center. Hot foods, cold drinks, sugar, or even sudden puffs of air can ride the tubules into the core of your tooth. Anyone with tooth sensitivity knows that it is both uncomfortable and embarrassing — there’s nothing sexy about that pained grimace after a sip of ice water.
So the first key to good tooth health is keeping your enamel shell strong. That can be a challenge all by itself. Consider this: Every minute of every day, our teeth are collecting a film of plaque — a combination of naturally occurring mouth bacteria, food sugars, and other substances. Food sugars come not just from the obvious sources — the sugar in candy, soda, and other sweets — but also from the natural sugars created during the breakdown of fruits, whole grain foods, and other carbohydrates. All these sugars feed the bacteria, which, in turn, produce acid that leeches calcium salts from enamel and weakens it. The process is called demineralization. As long as the bacteria and sugars remain in your mouth, the acid level will remain high — which is why sticky foods like raisins, jam, or gummy bears can wreak havoc on enamel long after you finish eating.
Once you stop eating a meal and clear food remnants out of your mouth (by, say, brushing), acid levels remain high for about 30 minutes or so before your saliva slowly returns everything back to normal. If you sip sugary drinks or snack continuously, your teeth may remain bathed in acid all day long, and if you have dry mouth from low saliva flow, the acid remains higher longer.
Plaque remains on the teeth unless you brush or floss it away. After about 24 hours, the soft plaque begins to harden into tartar, which cannot be removed by simple brushing. If tartar forms at or under the gum line, it can cause the gums (also called gingival) to become inflamed, causing redness, puffiness, and bad breath. This inflammation (or gingivitis) might not sound like a big deal—until you take the long view. Gingivitis is just the first stage of gum disease. Teeth are embedded in the jaw, held in place by connective tissue and surrounded by your gums. If tartar is not removed, toxins destroy the connective tissue and bacteria can invade the bone around your teeth, creating infection and causing bone loss (a condition known as periodontal disease). If periodontal disease is left untreated, the tooth becomes unanchored, loosens, and eventually falls out. For healthy teeth, then, start with some basic dental hygiene:
Limit the number of sugary foods (and low-quality carbohydrates) you eat during the day. Dried fruits, crackers, pretzels, cookies, and other foods that get stuck on or between teeth can be particularly devastating to enamel over time. Lollipops and hard candies are also detrimental since they bathe your back teeth in sugars for prolonged periods of time.
Limit your number of “eating episodes” during the day. If you nibble on something every 30 minutes, your mouth will always contain acid, and your enamel will be under constant attack. Of course, eating every few hours is normal and perfectly fine.
Avoid sugary drinks, including sodas, fruit juices, overly-sweetened coffee or tea, and sweetened waters. Many dentists also recommend avoiding all sugar-free diet beverages because they often contain citric, malic, or phosphoric acids that can be damaging to your teeth. If you must drink them, use a straw to bypass your teeth.
Brush your teeth after every meal. If you cannot brush, at least rinse your mouth with water to remove some food debris. Chewing sugarless gum can also help.
Floss at least once a day to remove food particles and plaque between teeth.
Visit the dentist at least once a year for a professional cleaning, or more frequently if your dentist recommends it. Many dentists recommend twice yearly visits to keep on top of tartar, but some people who are more susceptible to tooth decay and/or tartar build-up may need to go even more often.